Dear Scientist, prostate cancer almost ended my life by surprise. What’s the status of more effective tests and treatments?

Chas Rodgers, of San Diego, always stayed on top of his health, so his cancer diagnosis came as a shock. Speaking with researcher Thomas Paul, he pushes for bolder measures against this silent threat.

By Zach Giordano | video by Sam Crimmins| December 4, 2018

Charles “Chas” Rodgers

“In my mind, your body is like a car: If you don’t get annual maintenance checks or regular oil changes, something might come up that leaves you sitting by the side of the road,” says Charles “Chas” Rodgers, 50, who is speaking from experience in the fifth year since being diagnosed with prostate cancer. “I can’t afford to be stuck on the shoulder; my family needs me.”

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The truth in Rodgers’s words is vital. As any doctor will tell you, preventative care is a fundamental key to good health. Being up-to-date on your health status, knowing your family history, and staying ahead of things that could put your health at risk can mean the difference between a full life and a premature death.

In Rodgers’s case, this meant pushing for a test that his doctor was at first hesitant to administer. But Rodgers, a certified fitness coach and personal trainer, is not one to accept being told no lightly, especially when it comes to his well-being.

After years of surgery and rehabilitation, Rodgers recently spoke with Thomas Paul, director of Epigenetics Research at Pfizer’s labs in La Jolla, California, to whom he wrote a letter about his cancer journey. Their conversation gave both men a different perspective, including showing Rodgers that there is hard work being done to advance the treatment of the disease that changed his life and caught him—and his doctor—by surprise.

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A life-saving personal promise

After growing up in Dayton, Ohio, a star athlete, musician, and member of his local church choir, Rodgers joined ROTC at the University of Cincinnati before entering the U.S. Navy. During his service, as mandated by the military, he was required to get regular check-ups to ensure he was performing at his peak. When his service ended, he knew this was too important a habit to break.

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“My father was not a big part of my life and because of that there was a huge gap in my medical history,” Rodgers says. “So I decided that every year, on my birthday, I would get a physical.”

This tradition granted Rodgers peace of mind for years, allowing him to excel while being confident in his health. He moved out to California, married his wife and fathered three children, and stoked a passion for fitness into his own personal training and coaching business.

Chaz and his three children

It wasn’t until 2013, on his 45th birthday, that Rodgers’s yearly check-up regimen truly paid off. During this visit—armed with the knowledge that men over 40 are at a higher risk for health issues—he asked his doctor about a prostate exam. To his surprise, his request was dismissed as unnecessary. Rodgers pressed the issue, eventually getting his doctor to concede and administer the digital rectal exam used to check a patient’s prostate for signs of cancerous growth.

Soon after, Rodgers’s doctor called him to request an urgent meeting. Sitting down with his physician, Rodgers learned the news that no one wants to hear: They believe it’s cancer. A prostate-specific androgen (PSA) test, which checks a patient’s levels of androgen (a form of testosterone) and is used to diagnose and categorize prostate cancer, was immediately administered; Rodgers’s numbers were high. Then, a biopsy was taken, ultimately confirming their suspicions: All 15 samples taken were cancerous.

After sitting down with his surgeon and oncologist to design his treatment plan, Rodgers underwent a radical prostatectomy in early 2014 to remove his prostate before any cancerous cells could spread to other parts of his body, a phenomenon called metastasis. After a year and a half in recovery, Rodgers began radiation treatment in 2015, sitting 30 minutes a day, six days a week for nine weeks.

“Did you feel supported throughout all this?” Thomas Paul asks while seated across from Rodgers at Pfizer’s headquarters in La Jolla.

“This whole process is something no one can prepare you for,” Rodgers says. “I had few people around who really knew what I was going through.”

Rodgers suffered intense fatigue because of the radiation therapy, and experienced erectile dysfunction and a constant need to use the restroom as result of the prostatectomy. Going forward, Rodgers will take a PSA test every six months to monitor his androgen levels and ensure that the cancer has not returned. Still, Rodgers believes it was all worth it: “I’m still here, so whatever they did worked.”

Thomas Paul, director of Epigenetics Research at Pfizer

Looking ahead, Paul is optimistic about the treatment potential of two research areas: precision medicine and epigenetics. Precision medicine tailors treatments to a specific mutation or abnormality that caused the cancer. This helps avoid the assumption that everyone has the same form of the disease, hopefully leading to the reduction of broader treatments, like radiation, that are more one-size-fits-all in their approach to cancer suppression.

Epigenetics, the research category that Paul directs at Pfizer, studies changes in the identity or behavior of cancer cells that aren’t reflected in their genetic makeup—like how cells from your heart and cells from your skin contain the same DNA, but perform completely different functions in the body based on how they’re directed to behave.

“In prostate cancer, bone is a big area for metastases, and we’re learning that when the cancer cells move into your bone, they change because of the microenvironment they now exist in,” Paul says. “My team has begun to understand the changes that occur, and we’re now testing some new potential therapies that we’ve developed based on this knowledge.”

A push for progress

“Overall, what’s really key for treating any cancer is getting that early diagnosis,” Paul says. “You were very smart, and very lucky, to get that exam when you did. More men need to be proactive, work with their doctors, and ask for these tests, like you did.”

Rodgers agrees and also emphasizes that African American men are 1.7 more likely to be diagnosed with prostate cancer than non-Hispanic white men.

On this note, Rodgers asks his final question: When does cultural consideration come up, if ever, in the research process? “I want you to take a sense of urgency back to your team to consider who the tissues you’re studying are coming from, whether they’re African Americans or not, and to be more aware of the fact that this cancer does affect a specific population at a higher rate,” Rodgers says.

“I certainly will discuss this with my team,” Paul says. “It is important that we put energy into considering the ethnic backgrounds and other attributes of individuals that would help us understand some of these behaviors better. To create better medicine, we can’t just look at a cell in a petri dish, but instead must think of the patient and put a face to the research which will hopefully result in better, more specific treatment results in the future.”